Maternal Depression Screening

Maternal or caregiver health can affect young children’s development. Children with depressed mothers have increased risk of developmental concerns or delays such as behavior problems and poor cognitive outcomes. Despite evidence that maternal depression is common and can negatively affect the development of young children, it is often undiagnosed and untreated. Since the rate of depression is disproportionately higher among low-income women, Medicaid can play a leading role in identifying at-risk mothers and connecting them to treatment. In 2016, CMS issued a bulletin clarifying that state Medicaid agencies may allow maternal depression screenings to be claimed as a service for the child as part of the EPSDT benefit.
The American Academy of Pediatrics’ 4th edition of Bright Futures recommends maternal depression screening during the 1, 2, 4, and 6 month well-child visits.
Below there is a map that highlights state Medicaid policies around maternal depression screening during well-child visits, including reimbursement. A second map highlights recommended or required screening tools. A detailed chart of maternal depression screening policy information by state is here.
Learn more about how Virginia seeks to improve birth and maternal outcomes through behavioral risk screening (including maternal depression screening), case management services, and expanded prenatal services here.

Sources: State Medicaid websites and direct communication with state Medicaid officials

37 states have a policy to allow, recommend, or require maternal depression screening as part of a well-child visit

Accurate as of September 2018

Policy Trends

37 states recommend, require, or allow maternal depression screening to be provided as part of a well-child visit.

The most commonly used CPT code is 96161 and reported fee-for-service reimbursement rates range from $2.18 to $29.68.

11 states distinguish between positive and negative screens in claims data using specific codes or modifiers.

3 states (California, New Mexico and Texas) are in the process of implementing reimbursement or other guidelines, and 2 states (District of Columbia and Rhode Island) are in the process of updating reimbursement or other guidelines.

At least 4 states (Kentucky, Pennsylvania, Rhode Island, and Wisconsin) have performance measures related to maternal or perinatal depression screening.

State Medicaid Recommendations and Requirements for Maternal Depression Screening Tools

State Medicaid Recommendations and Requirements for Maternal Depression Screening Tools

In 14 states a primary caregiver can be screened for depression during a well-child visit.

State efforts to monitor referrals and maternal or caregiver health outcomes after a positive depression screening are still emerging. In Virginia, referrals for positive screenings are generated under managed care plans through mandated Maternity Programs, and Colorado plans to begin tracking outcome data in 2018.